Montana

The State of Montana received $300,000 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in FY 2022. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2022 to September 29, 2023.

The strategies focus on

  • Ensuring blood lead testing and reporting
  • Enhancing blood lead surveillance
  • Improving linkages to recommended services

To learn more about these efforts in Montana, contact the program below.

Montana Department of Public Health & Human Services
2401 Colonial Dr.
Helena, MT 59604
Phone: (406) 417-9848

Success stories refer to activities conducted between 2014 and 2019. Montana did not receive funding at this time and was not required to submit a success story.

Success Story 2023

Improving Blood Lead Surveillance in Children at Risk in Montana

Challenge

Prior to 2021, Montana did not have an active long-term childhood lead poisoning prevention program. The Administrative Rules of Montana (ARM) for reportable conditions and diseases only required laboratory reporting of venous-drawn blood lead results at or above 5 µg/dL. Montana Department of Public Health and Human Services (DPHHS) data from 2019 to 2020 showed that only 13% of children eligible for Medicaid were tested for blood lead compared with the estimated national testing prevalence of at least 45%. All children enrolled in Medicaid are required to be tested at ages 12 and 24 months. Further, using the results of a 2012 lead surveillance pilot study in Montana, DPHHS estimated that 88% of all children ages 1–2 years (regardless of Medicaid status) who may have had a blood lead level (BLL) of 5 µg/dL or higher went undetected during 2019–2020.

Intervention

In September 2021, the DPHHS launched the Montana Childhood Lead Poisoning Prevention Program (MT CLPPP) to increase blood lead testing for children younger than 6 years of age, enhance state-wide blood lead surveillance, and improve linkages to intervention services. DPHHS also conferred with local health jurisdictions about lowering Montana’s reportable BLL from 5 to 3.5 µg/dL to be consistent with CDC’s updated blood lead reference value. With strong support from partners, DPHHS drafted a rule amendment to the ARM for reportable conditions. DPHHS filed the amendment in July 2022, and it was adopted into the ARM two months later without opposition on September 24, 2022.

The ARM amendment expands reporting requirements to include all venous blood lead test results, regardless of BLL or age, and capillary blood lead test results ≥3.5 µg/dL for children younger than 16 years. MT CLPPP launched an outreach campaign to communicate these reporting rule changes to healthcare providers, laboratories, and local and tribal health jurisdictions.

Impact

The amendment to the blood lead reporting ARM has significantly increased the number of blood lead test results reported to the state. From September to December 2022, laboratories reported 73 cases with a BLL at or above 3.5 µg/dL compared with a yearly average of 17 cases from 2014 to 2019. By requiring more test results to be reported, the MT CLPPP will be able to improve state-wide blood lead surveillance and help identify children at risk of lead exposure sooner and connect them with recommended services. Outreach about the rule amendment has also increased awareness of MT CLPPP and lead poisoning prevention among local health jurisdictions and healthcare providers. By focusing on rule amendment, MT CLPPP will ensure the sustainability of Montana’s statewide lead poisoning prevention efforts.

Funding for this work was made possible in part by NUE2EH001420 from the CDC. The views expressed in this material do not necessarily reflect the official policies of the CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.